TY - JOUR
T1 - The Effect of Schizophrenia on Major Adverse Cardiac Events, Length of Hospital Stay and Prevalence of Somatic Comorbidities Following Acute Coronary Syndrome
AU - Attar, Rubina
AU - Valentin, Jan Brink
AU - Freeman, Phillip
AU - Andell, Pontus
AU - Aagaard, Jørgen
AU - Jensen, Svend Eggert
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.
PY - 2019/4
Y1 - 2019/4
N2 - Aims We aimed to investigate major adverse cardiac events (MACE: defined as all-cause mortality, re-infarction, and stroke), length of hospital stays (LOS), and comorbidities following acute coronary syndrome (ACS) in a population with schizophrenia. Methods and results This Danish register study included patients diagnosed with ACS in the period between 1995 and 2013 with a preceding diagnosis of schizophrenia (n = 726). Each patient was matched to a psychiatric healthy control 1:2 on sex, age, year of ACS diagnosis, and number of comorbidities (total n = 2178). After performing Cox regression and Kaplan-Meier analyses, we found that patients with schizophrenia had an increased risk of MACE [hazard ratio (HR) 1.62, 95% confidence interval (CI) 1.45-1.81], all-cause mortality (HR 2.54, 95% CI 2.22-2.90), and stroke (HR 1.51, 95% CI 1.15-1.99). No differences were found in the re-infarction rates and LOS between the populations. Patients with schizophrenia had higher prevalence's diabetes, anaemia, heart failure, cardiomyopathy, chronic obstructive lung disease, and stroke. Nonetheless, we found lower prevalence's of hypertension and hyperlipidaemia. Conclusion Schizophrenia is associated with an increased risk of MACE despite a lower prevalence of some diagnosed traditional cardiac risk factors which may indicate underdiagnosing of these. Awareness of treatment bias may improve this increased risk.
AB - Aims We aimed to investigate major adverse cardiac events (MACE: defined as all-cause mortality, re-infarction, and stroke), length of hospital stays (LOS), and comorbidities following acute coronary syndrome (ACS) in a population with schizophrenia. Methods and results This Danish register study included patients diagnosed with ACS in the period between 1995 and 2013 with a preceding diagnosis of schizophrenia (n = 726). Each patient was matched to a psychiatric healthy control 1:2 on sex, age, year of ACS diagnosis, and number of comorbidities (total n = 2178). After performing Cox regression and Kaplan-Meier analyses, we found that patients with schizophrenia had an increased risk of MACE [hazard ratio (HR) 1.62, 95% confidence interval (CI) 1.45-1.81], all-cause mortality (HR 2.54, 95% CI 2.22-2.90), and stroke (HR 1.51, 95% CI 1.15-1.99). No differences were found in the re-infarction rates and LOS between the populations. Patients with schizophrenia had higher prevalence's diabetes, anaemia, heart failure, cardiomyopathy, chronic obstructive lung disease, and stroke. Nonetheless, we found lower prevalence's of hypertension and hyperlipidaemia. Conclusion Schizophrenia is associated with an increased risk of MACE despite a lower prevalence of some diagnosed traditional cardiac risk factors which may indicate underdiagnosing of these. Awareness of treatment bias may improve this increased risk.
KW - Acute coronary syndrome
KW - Myocardial infarction
KW - Psychiatry
KW - Quality of care
KW - Schizophrenia
KW - Length of Stay/trends
KW - Prevalence
KW - Follow-Up Studies
KW - Humans
KW - Middle Aged
KW - Risk Factors
KW - Acute Coronary Syndrome/epidemiology
KW - Male
KW - Schizophrenia/epidemiology
KW - Cause of Death/trends
KW - Incidence
KW - Denmark/epidemiology
KW - Survival Rate/trends
KW - Female
KW - Registries
KW - Retrospective Studies
KW - Risk Assessment/methods
KW - Comorbidity/trends
UR - http://www.scopus.com/inward/record.url?scp=85063316139&partnerID=8YFLogxK
U2 - 10.1093/ehjqcco/qcy055
DO - 10.1093/ehjqcco/qcy055
M3 - Journal article
C2 - 30496375
VL - 5
SP - 121
EP - 126
JO - European heart journal. Quality of care & clinical outcomes
JF - European heart journal. Quality of care & clinical outcomes
SN - 2058-1742
IS - 2
ER -